91 Yaşındaki Aktif Hastada Unstabil Pertorakhanterik Kırık Nedeniyle Uygulanan Proksimal Femoral Çivinin (PFN) Proksimalden İki Kez Kırılması

Toplumda yaşam süresinin uzamasıyla beraber, ileri yaş hasta popülasyonunun artışına bağlı pertorakhanterik kalça kırıkları daha sık görülür hale gelmiştir. Özellikle unstabil pertorakhanterik kalça kırıklarında kırığın internal rijid fiksayonu ve hastanın erken mobilizasyonu için Proksimal Femoral Nail (PFN) sıklıkla tercih edilir. PFN sonrası proksimal kayıcı vidanın geri gelmesi veya kırılması, distal vidanın kırılması, PFN’ nin proksimal veya distalden kırılması gibi implant yetmezlik bulguları nadir olarak görülür. Bizim vakamızda unstabil pertorakhanterik kalça kırıklı ileri yaş aktif kadın hastamızın, PFN sonrası iki kez proksimal PFN kırığı gelişimi ve iki kez PFN+ grefle revizyonu sunuldu. Literatürde 91 yaşında, düşme veya yüksek enerjili travma olmadan iki kez proksimal PFN kırığı gelişen ve PFN ile revizyon uygulanan başka vakaya rastlamadığımız için bu olguyu sunduk.

Anahtar Kelimeler:

Femur, Kalça, Pertorakhanterik, PFN

91 Year Old Active Patient, Two Proksimal Fractures of The Proksimal Femoral Nail (PFN) Applied Due to Unstable Perthorachanteric Fracture

With prolonged life expectancy in society and an increasing elderly patient population, pertrochanterıc hip fractures have become more common. Particularly in unstable pertrochanteric hip fractures, Proximal Femoral Nail (PFN) is often preferred for internal rigid fixation of the fracture and early mobilization of the patient. Implant failure findings such as relapse or fracture of the proximal sliding screw after PFN, fracture of the distal screw, and fracture of the PFN from the proximal or distal area are rare. We present the case of an advanced-age active female patient with an unstable pertrochanteric hip fracture who developed two proximal PFN fractures after PFN, and we document the two revisions with PFN+ graft we introduced for her. We present this case because in the literature we had not encountered any 91-year-old patient who developed proximal PFN fractures twice without falling or high-energy trauma and who achieved union of the fracture with through revisions performed twice with PFN and graft.

Keywords:

Femur, Hip, Pertrochanteric, PFN,

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